Duration of endotracheal intubation and candidemia in very low-birth-weight infants

This study was to determine the risk factor for candidemia in very low-birth-weight (VLBW) infants. Medical records of VLBW infants admitted to a neonatal intensive care unit between January 1989 and March 1996 were reviewed. For each candidemic infant, two matching uninfected infants were selected who were admitted at about the same time as the former and had closely comparable birth weights. Information such as the duration of intubation, antibiotic therapy, central venous catheter, parenteral nutrition and dexamethasone therapy was collected for analysis. Altogether, 357 VLBW infants were admitted to the unit during the period of which 17 (4.8% had candidemia. The risk for candidemia increased significantly (Odds ratio, 11.5; 95% CI, 1.2-108.0) with endotracheal intubation longer than 7 days in duration. Whereas, antibiotic treatment, central venous catheter, parenteral nutrition and dexamethasone therapy on the other hand were not associated with candidemia. Conclusions: endotracheal intubation lasting more than one week increases the risk for candidemia in the VLBW infants. It is unclear whether shortening the duration of intubation could reduce the risk of candidemia and deserves further investigation.